Endometriosis treatment: How to treat Endometriosis naturally for long-lasting relief
Severe period pain and endometriosis have become so common that most people think they’re normal.
If you’re living with endometriosis, you’ve probably come to dread that time of the month.
But what if we told you, severe period pain isn’t normal?
One recent study found 92 percent of Australians with periods experienced pain with their menstrual cycle. The pain was so severe for more than three-quarters of them that it interfered with their work, while more than 60 percent had to leave work early or take time off.
This same study also revealed that 67 percent of people with severe menstrual pain either didn’t tell their employer about it or gave another reason for any lack of concentration or absence from work.
This speaks volumes about the level of shame that still surrounds menstrual pain and conditions like endometriosis, and the associated stress that can further exacerbate pain levels.
Even the conventional medicine field is trailing behind in understanding and acknowledging the challenges of endometriosis, with many people waiting years for an accurate diagnosis before any medical support can begin.
If you’re living with endometriosis, or suspect you might be, you’re probably looking for answers.
Despite what you might have been told, you do have options other than popping a pill or suffering in silence.
Endometriosis treatment: what is Endometriosis?
Endometriosis is a painful, inflammatory reproductive health condition affecting one in ten women who menstruate. Endometriosis involves endometrial tissue deposits growing in parts of the body other than the uterus, such as the pelvic cavity, ovaries, fallopian tubes, or bowel. The tissue thickens until menstruation occurs and these deposits shed, causing bleeding to pool inside the body, which typically results in pain, scarring, adhesions, and sometimes infertility.
Signs and symptoms of Endometriosis
- Pain: Pain before and during a period, during or after sex (also called dyspareunia), abdominal, lower back or pelvic pain, pain on going to the toilet, passing urine, opening bowels; ovulation pain, including pain in the thigh or leg; pain that gets worse over time; severe pain that prevents participation in normal activities.
- Bleeding: Heavy or irregular vaginal bleeding
- Bladder and bowel problems: Changes in bowel and bladder movements, bleeding, pain
- Bloating: Abdominal bloating, ‘pregnant’ appearance
- Tiredness: Fatigue and lethargy
- Mood changes: Anxiety, depression or low mood
- Reduced quality of life: Missing school, work, family and social interaction
- Vaginal discomfort: Pelvic floor dysfunction and painful intercourse
- Infertility: Between 25 to 50% of infertile women have endometriosis, and 30 to 50% of women with endometriosis are infertile.
As many as one in four women with endometriosis may not experience these common endometriosis symptoms, and may not discover they have endometriosis until they encounter fertility issues or undergo surgery for other reasons.
Endometriosis can be difficult to diagnose, with an average of seven years between the onset of symptoms and diagnosis. These delays can exacerbate the mental health challenges that often coincide with endometriosis, and many people with the condition report feeling unheard - as though their medical practitioners either aren’t listening or don’t believe the level of pain they’re experiencing.
Common and conventional Endometriosis treatments
There is no proven cure for endometriosis, however, conventional medical practitioners do offer a range of treatment options, including:
- Pain killers: May provide temporary relief of pain but do not treat the condition or stop the cycle of endometrial lesions forming and shedding.
- Oral contraceptive pill: The placebo pills can be skipped to prevent monthly bleeding, which reduces symptoms but also does not treat the condition.
- Hormonal treatments: Synthetic hormones can be used to reduce the level of oestrogen, which is often dominant in people with endometriosis.
- Surgery: Laparoscopy or laparotomy can be used to remove endometrial lesions. This may reduce symptoms, but doesn’t address the underlying hormonal imbalance.
- Hysterectomy: In severe cases, the uterus can be removed, however, symptoms can still occur, as well as cause new symptoms, and this option is not suitable for those planning to conceive.
Because these conventional treatments for endometriosis fail to address the underlying contributing factors, they have limited effectiveness. One recent review found up to 59 percent of women who underwent conventional treatment for endometriosis had pain remaining, 34 percent had a recurrence of symptoms after treatment cessation, and up to 19 percent of women reported no reduction in pain at all.
Causes of Endometriosis and contributing factors
The causes of endometriosis and contributing factors are multifaceted, but all mostly stem back to hormonal imbalances, inflammation and physiological factors.
Some of the links that have been uncovered to date, include:
- Family history: Studies have found an increased risk of developing endometriosis among people with a first or second degree relative with the condition, including twins.
- Retrograde menstruation: Retrograde menstruation, where menstrual blood enters the pelvic cavity via the fallopian tubes, occurs in up to 90 percent of menstruating people. However the amount of menstrual fluid found in the pelvis of people with endometriosis is far greater than that of healthy people, and rather than being cleared by the body, endometrial tissue then starts to grow.
- Compromised gut health: There is a high level of gram-negative bacteria and the associated toxin lipopolysaccharide (LPS) in the pelvic microbiome of people with endometriosis, most likely translocated from the gut. There is also a strong association with endometriosis and irritable bowel, and ‘leaky gut’ or increased intestinal permeability.
- Inflammation and immune health: LPS is known to induce inflammation as well as immune dysfunction. The endometriosis-associated inflammatory responses are linked to activated macrophages and secreted cytokines in peritoneal fluid. This inflammation not only causes pelvic pain but impairs tubal anatomy and ovarian function, decreases egg and embryo quality, reduces implantation likelihood, and can lead to infertility. Growing research also supports immune dysfunction involvement in endometriosis, evidenced by the presence of autoantibodies.
- Hormonal imbalance: Endometriosis is associated with elevated levels of oestrogen, which may be expressed as heavy or long-lasting periods, early onset of menstruation, and less than 27 days between bleeds. Hormonal imbalance can result from a range of factors including compromised liver function, and high stress levels.
The Melbourne Functional Medicine approach to Endometriosis
Our practitioners address endometriosis with a functional medicine approach, using functional testing to determine individual underlying factors, before recommending a personalised protocol.
For people with endometriosis, the protocol will usually involve nutrition, herbal medicines, gut health support, and lifestyle changes including exercise, sleep, relaxation, and mindfulness.
Reduce inflammation: When addressing any inflammatory condition, the priority is to reduce inflammation, and that starts with food. An anti-inflammatory elimination diet is a low GI diet free from gluten, dairy, refined sugars, alcohol and caffeine, but rich in vegetables, fruits, and healthy fats like avocado, nuts, seeds, and seafood - organic where possible to avoid inflammatory pesticides. Dark green vegetables like kale, spinach, broccoli and chard, beta-carotene rich foods like carrots, capsicum and mangoes have all shown to reduce the inflammatory response. Plant-based and herbal medicines with anti-inflammatory properties such as rosemary, curcumin, white peony, and rehmannia, can also be used.
Restore gut health: Our practitioners can use functional testing to determine the presence of bacterial colonisation and pathogenic processes in the intestinal and vaginal microbiome. Improving digestion, healing and sealing the gut, and restoring balance to the microbiota with probiotics, such as Lactobacillus rhamnosus BPL005 has been shown to reduce bacterial colonisation of endometrial epithelial cells, potentially improving outcomes for people with endometriosis.
Support the immune system: Dysregulation of immune cells occurs in many cases of endometriosis, and links have been made between the condition and several autoimmune diseases including coeliac disease, lupus, rheumatoid arthritis, multiple sclerosis and inflammatory bowel disease. This aspect of endometriosis can be addressed with immune-supporting nutrients such as omega-3 fatty acids like fish, eggs, flaxseeds, as well as Vitamin D. Following an autoimmune protocol diet may be suitable for some people with endometriosis.
Regulate hormones: This may include discovering the primal wisdom of the menstrual cycle and aligning your work and social schedule with the phases of your cycle. Historically, menstrual and fertility cycles were closely aligned with the cycles of the moon. It is believed many factors of our modern lifestyles including busy schedules, artificial light, indoor living and environmental hormone disruptors have caused a disconnect with these cycles, contributing to hormonal imbalances and menstrual irregularities. One such cause is the presence of xenoestrogens - chemicals that mimic oestrogen in the body, commonly found in everything from plastic containers to skincare, perfume and shampoo. Research has found exposure to xenoestrogens increases the risk of endometriosis and may lead to reduced fertility.
Reduce stress: Elevated stress levels contribute to hormonal imbalance, impacting adrenal, and thyroid function. This creates a knock-on effect on the delicate balance of all hormones and can lead to elevated liver enzymes and impaired liver function, which further exacerbates high oestrogen levels by interrupting hormone detox pathways. Research has found that the anticipation of pain, such as fear or stress surrounding the monthly menstrual cycle, can create heightened pain perception. This is not to suggest endometriosis pain is in any way ‘in your head’ - it is not. But relaxation, mindfulness, breathing techniques, and even hypnosis can all be effective in helping to manage endometriosis-related pain, along with a healthy change of mindset and thought processes about menstruation.
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